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VOLUME 24 , ISSUE 3 ( March, 2023 ) > List of Articles

ORIGINAL RESEARCH

Knowledge and Practice of Radiation Stents for Oral Cancer Patients among the Sudanese's Maxillofacial Surgeons, Prosthodontists, Oncologists, and Radiotherapists

Rufida Mohamed Suliman, Fadia Awadalkreem

Keywords : Knowledge, Oral cancer, Practice, Radiation stent, Treatment

Citation Information : Suliman RM, Awadalkreem F. Knowledge and Practice of Radiation Stents for Oral Cancer Patients among the Sudanese's Maxillofacial Surgeons, Prosthodontists, Oncologists, and Radiotherapists. J Contemp Dent Pract 2023; 24 (3):168-175.

DOI: 10.5005/jp-journals-10024-3491

License: CC BY-NC 4.0

Published Online: 25-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: To assess the knowledge and practice of radiation stents for oral cancer patients among the Sudanese's maxillofacial surgeons, prosthodontists, oncologists, and radiotherapists in Khartoum state. Materials and methods: A self-administered questionnaire composed of three sections, including the participant's sociodemographic, knowledge, and practice data, was conducted and distributed among the specialists and Registrars of maxillofacial surgery, prosthodontics, oncology, and radiotherapy who were working at the Khartoum Teaching Dental Hospital, the Faculty of Dentistry (University of Khartoum), and the Khartoum Oncology Hospital, respectively, during the study's duration. A cluster sampling technique was used, and within the cluster group, simple randomization was used. The sample size was 137 participants. The participant's knowledge and practice scores were calculated as percentages achieved by dividing the numbers of the accurate answers of the participants by the total number of questions and categorized as good (66.6%–100%), average (33.3%–66.6%), and poor (less than 33.3%). Result: The response rate was 80%. Forty five (40.9%) of the respondents were males, and 65 (59.1%) were females. The high-frequency age-group was 30–40 years (59 subjects, 53.6%). Thirty-eight participants (75.5%) were unfamiliar with the radiation stent. The overall knowledge score was poor, with a significant difference between the different groups (p = 0.0001*). Only the prosthodontists reported a good level of knowledge about the radiation stent (73%), while the oncologists and the radiologists showed a zero level of knowledge. Despite this, the practice score of the radiation stent was poor among all groups. The level of knowledge regarding the complications of radiation and the different protective measures among the maxillofacial surgeons, oncologists, and radiotherapists was 55%, 60%, and 50%, respectively, while the prosthodontists reported 70%. Only 27 (24.5%) participants reported a multidisciplinary treatment approach. At the same time, the majority, 59.1%, declared that they do not follow a formal clinical guideline and/or protocol for dental treatment in oral cancer patients. The lack of knowledge and communication between the different health providers were the main barriers preventing the use of radiation stents. Conclusion: The knowledge and practice of the radiation stent were poor. A highlighted need was strengthened to improve the training and communication among the multidisciplinary oral cancer team members, and standard clinical guidelines and protocols need to be conducted and followed to improve patient treatment outcomes. Clinical significance: Radiation stents have a significant role in reducing the complications of radiation therapy. Improving the knowledge and practice of radiation stents will have a substantial influence on the quality of health services provided for the oral cancer patients and their quality of life.


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  1. Kujan O, Farah CS, Johnson NW. Oral and oropharyngeal cancer in the Middle East and North Africa: Incidence, mortality, trends, and gaps in public databases as presented to the Global Oral Cancer Forum. Transl Res Oral Oncol 2017;2. DOI: 10.1177/2057178X17698480.
  2. Saeed IE, Weng HY, Mohamed KH, et al. Cancer incidence in Khartoum, Sudan: First results from the Cancer Registry, 2009–2010. Cancer Med 2014;3(4):1075–1084. DOI: 10.1002/cam4.254.
  3. Huang SH, O'Sullivan B. Oral cancer: Current role of radiotherapy and chemotherapy. Med Oral Patol Oral Cir Bucal 2013;18(2):e233–e240. DOI: 10.4317/medoral.18772.
  4. Beumer J, Curtis TA, Nishimura R. Radiation therapy of head and neck tumors: Oral effects and dental manifestation. In maxillofacial Rehabilitation Prosthodontic and Surgical Consideration. Ishiyaku EuroAmerica, Incorporated 1996;2nd edn, pp: 43–111.
  5. Nambiar KS, Haragannavar VC, Augustine D, et al. Adverse effects of radiotherapy on oral tissues: A review. Int J Contemp Dent Med Rev 2016;2016:1–5.
  6. Tanaka TI, Chan HL, Tindle DI, et al. Updated clinical considerations for dental implant therapy in irradiated head and neck cancer patients. J Prosthodont 2013;22(6):432–438. DOI: 10.1111/jopr.12028.
  7. Vissink A, Burlage FR, Spijkervet FK, et al. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003;14(3):213–225. DOI: 10.1177/154411130301400306.
  8. Pinna R, Campus G, Cumbo E, et al. Xerostomia induced by radiotherapy: An overview of the physiopathology, clinical evidence, and management of the oral damage. Ther Clin Risk Manag 2015;11:171–188. DOI: 10.2147/TCRM.S70652.
  9. Jham BC, da Silva Freire AR. Oral complications of radiotherapy in the head and neck. Braz J Otorhinolaryngol 2006;72(5):704–708. DOI: 10.1016/s1808-8694(15)31029-6.
  10. Imanimoghaddam M, Rahrooh M, Tafakhori Z, et al. Changes of parotid and submandibular glands caused by radiotherapy – An ultrasound evaluation. Dentomaxillofac Radiol 2012;41:379–384. DOI: 10.1259/dmfr/17113005.
  11. Jensen SB, Vissink A, Limesand KH, et al. Salivary gland hypofunction and xerostomia in head and neck radiation patients. J Natl Cancer Inst Monogr 2019;2019(53):lgz016. DOI: 10.1093/jncimonographs/lgz016.
  12. Lalla RV, Brennan MT, Gordon SM, et al. Oral mucositis due to high-dose chemotherapy and/or head and neck radiation therapy. J Natl Cancer Inst Monogr 2019;2019(53):lgz011. DOI: 10.1093/jncimonographs/lgz011.
  13. Kielbassa AM, Hinkelbein W, Hellwig E, et al. Radiation-related damage to dentition. Lancet Oncol 2006;7(4):326–335. DOI: 10.1016/S1470-2045(06)70658-1.
  14. Baharvand M, ShoalehSaadi N, Barakian R, et al. Taste alteration and impact on quality of life after head and neck radiotherapy. J Oral Pathol Med 2013;42(1):106–112. DOI: 10.1111/j.1600-0714.2012.01200.x.
  15. Bensadoun R-J, Riesenbeck D, Lockhart PB, et al. A systematic review of trismus induced by cancer therapies in head and neck cancer patients. Support Care Cancer 2010;18(8):1033–1038. DOI: 10.1007/s00520-010-0847-4.
  16. Beech N, Robinson S, Porceddu S, et al. Dental management of patients irradiated for head and neck cancer. Aust Dent J 2014;59(1):20–28. DOI: 10.1111/adj.12134.
  17. Walker MP, Wichman B, Cheng AL, et al. Impact of radiotherapy dose on dentition breakdown in head and neck cancer patients. Pract Radiat Oncol 2011;1(3):142–148. DOI: 10.1016/j.prro.2011.03.003.
  18. Thorn JJ, Hansen HS, Specht L, et al. Osteoradionecrosis of the jaws: Clinical characteristics and relation to the field of irradiation. J Oral Maxillofac Surg 2000;58(10):1088–1093; discussion 1093–1095. DOI: 10.1053/joms.2000.9562.
  19. Lambade PN, Lambade D, Goel M. Osteoradionecrosis of the mandible: A review. Oral Maxillofac Surg 2013;17(4):243–249. DOI: 10.1007/s10006-012-0363-4.
  20. Jacobson AS, Buchbinder D, Hu K, et al. Paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol 2010;46(11):795–801. DOI: 10.1016/j.oraloncology.2010.08.007.
  21. Lyons A, Ghazali N. Osteoradionecrosis of the jaws: Current understanding of its pathophysiology and treatment. Br J Oral Maxillofac Surg 2008;46(8):653–660. DOI: 10.1016/j.bjoms.2008.04.006.
  22. Jansma J, Vissink A, Spijkervet FK, et al. Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy. Cancer 1992;70(8):2171–2180. DOI: 10.1002/1097-0142(19921015)70:8<2171::aid-cncr2820700827>3.0.co;2-s.
  23. Pavlatos J, Gilliam KK. Oral care protocols for patients undergoing cancer therapy. Gen Dent 2008;56:464–478. PMID: 18683404.
  24. Friedland PL, Bozic B, Dewar J, et al. Impact of multidisciplinary team management in head and neck cancer patients. Br J Cancer 2011;104(8):1246–1248. DOI: 10.1038/bjc.2011.92.
  25. MacCarthy D, Omer O, Nunn J, et al. Oral health needs of the head and neck radiotherapy patient: 1. Epidemiology, effects of radiotherapy and role of the GDP in diagnosis. Dent Update 2005;32(9):512–514, 516–518, 521–522. DOI: 10.12968/denu.2005.32.9.512.
  26. Barclay SC, Turani D. Current practice in dental oncology in the UK. Dent Update 2010;37(8):555–558, 560–561. DOI: 10.12968/denu.2010.37.8.555.
  27. Mantri SS, Bhasin AS, Shankaran G, et al. Scope of prosthodontic services for patients with head and neck cancer. Indian J Cancer 2012;49(1):39–45. DOI: 10.4103/0019-509X.98917.
  28. Verrone JR, Alves Fde A, Prado JD, et al. Impact of intraoral stent on the side effects of radiotherapy for oral cancer. Head Neck 2013;35(7):E213–E217. DOI: 10.1002/hed.23028.
  29. Fleming TJ, Rambach SC. A tongue-shielding radiation stent. J Prosthet Dent 1983;49(3):389–392. DOI: 10.1016/0022-3913(83) 90283-4.
  30. Aggarwal H, Kumar P. Radiation stents: Minimizing radiation-induced complications. South Asian J Cancer 2014;3(3):185. DOI: 10.4103/2278-330X.136812.
  31. Doi H, Tanooka M, Ishida T, et al. Utility of intraoral stents in external beam radiotherapy for head and neck cancer. Rep Pract Oncol Radiother 2017;22(4):310–318. DOI: 10.1016/j.rpor.2017.03.002.
  32. Zaid M, Bajaj N, Burrows H, et al. Creating customized oral stents for head and neck radiotherapy using 3D scanning and printing. Radiat Oncol 2019;14(1):148. DOI: 10.1186/s13014-019-1357-2.
  33. Verrone JR, Alves FA, Prado JD, et al. Benefits of an intraoral stent in decreasing the irradiation dose to oral healthy tissue: Dosimetric and clinical features. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118(5):573–578. DOI: 10.1016/j.oooo.2014.08.008.
  34. Johnson B, Sales L, Winston A, et al. Fabrication of customized tongue-displacing stents: Considerations for use in patients receiving head and neck radiotherapy. J Am Dent Assoc 2013;144(6):594–600. DOI: 10.14219/jada.archive.2013.0170.
  35. Taniguchi H. Radiotherapy prostheses. J Med Dent Sci 2000;47(1): 12–26. PMID: 12162523.
  36. Gupta R, Luthra RP, Gautam D. Radiation prosthesis: A review. Int J Contemp Dent Med Rev 2016:1–4.
  37. Rocha BA, Lima LMC, Paranaíba LMR, et al. Intraoral stents in preventing adverse radiotherapeutic effects in lip cancer patients. Rep Pract Oncol Radiother 2017;22(6):450–454. DOI: 10.1016/j.rpor.2017.08.003.
  38. Hou Z, Li S, Jiang Y, et al. Benefits of intraoral stents for sparing normal tissue in radiotherapy of nasopharyngeal carcinoma: A radiobiological model-based quantitative analysis. Transl Cancer Res 2021;10(10):4281–4289. DOI: 10.21037/tcr-21-1324.
  39. Appendino P, Della Ferrera F, Nassisi D, et al. Are intraoral customized stents still necessary in the era of highly conformal radiotherapy for head and neck cancer? Case series and literature review. Rep Pract Oncol Radiother 2019;24(5):491–498. DOI: 10.1016/j.rpor.2019.07.012.
  40. Goel A, Tripathi A, Chand P, et al. Use of positioning stents in lingual carcinoma patients subjected to radiotherapy. Int J Prosthodont 2010;23(5):450–452. PMID: 20859562.
  41. Fotedar V, Fotedar S, Gupta M, et al. Oral cancer knowledge, attitudes and practices: A survey of undergraduate medical students in Himachal Pradesh, India. J Clin Diagn Res 2015;9(8):XC05–XC08. DOI: 10.7860/JCDR/2015/12752.6406.
  42. Pai RR, Ongole R. Nurses’ knowledge and education about oral care of cancer patients undergoing chemotherapy and radiation therapy. Indian J Palliat Care 2015;21(2):225–230. DOI: 10.4103/0973-1075.156507.
  43. Suhaimi A. Awareness of pre-radiation dental assessment of head and neck cancer patients among dentists in Malaysia and New Zealand, in Special Needs Dentistry. University of Otago: Dunedin, New Zealand; 2017. https://ourarchive.otago.ac.nz/handle/10523/7721.
  44. Babiker TM, Osman KA, Mohamed SA, et al. Oral cancer awareness among dental patients in Omdurman, Sudan: A cross-sectional study. BMC Oral Health 2017;17(1):69. DOI: 10.1186/s12903-017-0351-z.
  45. Almahmoud Idris AA, Aldouma SM, Mohammed FA. Awareness of Sudanese Primary Health Care Workers about Oral Cancer. IJAPR 2021;5(8):9–16. DOI: http://repo.nusu.edu.sd/xmlui/handle/123456789/334
  46. Ahmed NHM, Naidoo S. Oral cancer knowledge, attitudes, and practices among dentists in Khartoum State, Sudan. J Cancer Educ 2019;34(2):291–296. DOI: 10.1007/s13187-017-1300-x. PMID: 29151257.
  47. Chaudhary S, Gowda TM, Kumar TA, et al. Knowledge, attitudes, and perceptions of undergraduate dental students toward dental implants--an all India survey. Implant Dent 2015;24(2):160–165. DOI: 10.1097/ID.0000000000000184.
  48. Brody S, Omer O, McLoughlin J, et al. The dentist's role within the multi-disciplinary team maintaining quality of life for oral cancer patients in light of recent advances in radiotherapy. J Ir Dent Assoc 2013;59(3):137–146. PMID: 23858630.
  49. Shellenberger TD, Weber RS. Multidisciplinary team planning for patients with head and neck cancer. Oral Maxillofac Surg Clin North Am 2018;30(4):435–444. DOI: 10.1016/j.coms.2018.06.005.
  50. Sroussi HY, Epstein JB, Bensadoun RJ, et al. Common oral complications of head and neck cancer radiation therapy: Mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med 2017;6(12):2918–2931. DOI: 10.1002/cam4.1221.
  51. Patel Y, Bahlhorn H, Zafar S, et al. Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy. J Mich Dent Assoc 2012;94(7):34–45. PMID: 22970504.
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